New Research on Dairy’s Role in Prevention of Type 2 Diabetes
Type 2 diabetes affects an estimated 30 million American adults and accounts for the majority (90 to 95 percent) of all diagnosed cases of diabetes, according to the Centers for Disease Control and Prevention (CDC). The good news? A growing body of evidence indicates that dairy foods may be associated with a lower risk for developing Type 2 diabetes. Dietary recommendations are also beginning to shift toward accepting full-fat dairy foods as part of a healthy eating pattern for patients with diabetes.
While healthy eating patterns, physical activity and weight management are all keys to preventing chronic diseases, such as Type 2 diabetes, more and more research is pointing to the role dairy plays. The Dietary Guidelines for Americans (DGA) recommend three servings of low-fat or fat-free dairy foods daily for ages 9 and older, due to dairy’s contribution of key shortfall nutrients: calcium, potassium and vitamin D. The DGA also notes moderate evidence that healthy eating patterns including low-fat or fat-free dairy foods are linked to a lower risk of Type 2 diabetes among adults.
Evidence for Prevention With Dairy
All the evidence to date indicates that milk and dairy foods, as part of a balanced diet, regardless of fat level, are associated with a reduced risk of developing Type 2 diabetes. Yogurt and whole milk appear to be particularly beneficial.
- A 2017 meta-analysis published by Tian et al., which looked at results from 11 prospective cohort studies, found that higher intakes of dairy foods, including yogurt and whole milk in particular, were associated with a lower risk of Type 2 diabetes – indicating an 11 to 17 percent risk reduction, with yogurt providing the greatest reduction in risk.
- A 2016 comprehensive systematic review of prospective research on dairy and chronic disease (including Type 2 diabetes) conducted by Drouin-Chartier et al. found high-quality evidence that low-fat dairy foods, as well as yogurt specifically, are associated with a lower risk for Type 2 diabetes. There was also moderate-quality evidence that total dairy consumption, as well as cheese consumption, is associated with a lower risk.
Although the potential mechanisms are not entirely clear, dairy’s role in prevention seems to be due to its calcium, vitamin D, fatty acids and proteins, as well as its probiotic effects on the gut microbiome.
While more research is needed (specifically on individual dairy foods like milk, cheese and yogurt), these studies and others build on the current body of evidence for a positive association between dairy foods and lower risk for Type 2 diabetes.
Nutrition Guidelines More Open to Dairy Fat
In October 2016, the Joslin Diabetes Center – a world-renowned, Harvard-affiliated hospital as well as one of the 17 DRCs (diabetes research centers) in the United States designated by the National Institute of Health – updated their Joslin Clinic Clinical Nutrition Guideline for Overweight and Obese Adults With Type 2 Diabetes and Prediabetes or Those at High Risk for Developing Type 2 Diabetes to recognize recent advancements in nutrition science that support the idea that saturated fat from dairy foods (milk, cheese and yogurt) may be acceptable within total daily caloric intake. Specifically, the new guidelines:
- Increase the total dairy fat recommendation to less than 40 percent of calories (up from less than 35 percent of calories), allowing for more full-fat dairy foods to be recommended for patients with pre-diabetes and diabetes.
- Replace nonfat and low-fat dairy food terminology with a broader “dairy food” descriptor, indicating support for all fat varieties of dairy foods.
- Positively reference dairy foods as being associated with a reduced risk of developing Type 2 diabetes.
Joslin Diabetes Center is the first authoritative body in diabetes treatment to recognize this evidence in its nutritional guidelines. Additionally, given the emerging evidence and that it’s not clear whether high fat or low fat dairy have different effects on glycemic control and other cardiovascular risk factors in patients with Type 2 diabetes, Joslin currently has research underway that will help them better understand the role of fat in dairy foods in diabetes – particularly as it relates to weight management, glycemic control and cardio-metabolic risk factors.